MEDICARE: DR. SMITA REWARI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	23904	TX

General Provider Information

NPI Number	:	1790934198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SMITA REWARI DDS

Provider Business Mailing Address
First Line	:	1218 SW MILITARY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-1535
Country	:	US
Telephone Number	:	210-928-2814
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 S CAPITAL OF TEXAS HWY
Second Line	:	A-2
City	:	AUSTIN
State	:	TX
Zip	:	78746-8101
Country	:	US
Telephone Number	:	512-328-4867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	11/19/2009

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